Bariatric surgery isn’t ‘cheating,’ and other weight loss facts

Bariatric surgery isn’t ‘cheating,’ and other weight loss facts

Dr. Lane with a patient.

By Jennifer Lane, M.D.Bariatric and general surgeon in Medford and the Center for Weight Management and Weight-Loss Surgery

There is no guarantee of results. Results may vary.

Most of us have struggled to lose five to 10 pounds. But when your health and quality of life depend on losing 100-plus pounds, weight loss surgery may be an option to lose the weight and keep it off for good.

My patients come see me when they’re ready to make the healthy choice to improve or prevent weight-related health issues, such as diabetes, high blood pressure, or sleep apnea. They start out with body mass indexes of 35 or higher, when a healthy BMI is 18-25.

Putting your own health first may be a big change, particularly if you’ve always focused on your family or career responsibilities. Our weight loss surgery team can help you prioritize and optimize your health when you’re ready to lead a happier, more active life. Many of our patients are able to achieve their goals and enjoy life-changing results.

Bariatric surgery is not ‘cheating’

Contrary to popular belief, weight loss surgery isn’t “cheating.” I make a point to bring this up during initial consultations. Surgery doesn’t lose the weight for you. It doesn’t allow you to eat terribly and stay slender post-surgery. Surgery is just a tool to help you reach your goals.

Bariatric surgery isn’t magic. And it requires a lot of work leading up to the surgery and afterward.

Actually, losing weight with bariatric surgery is more complex than a dietary or exercise plan. There is a three- to six-month timeline between the initial visit and the surgery. For a complex, lifechanging surgery like this, it’s important to be well-prepared and well-educated to keep the weight off long term.

There are many steps to take before bariatric surgery

The first step is to make sure your insurance carrier covers bariatric surgery. Most do, including Medicaid and Medicare.

Next, you’ll attend an in-person or online information session, after which you’ll have an initial visit with me or Dr. Andras Sandor and our dietitian. Many weight loss centers host group sessions and you won’t meet your doctor until right before surgery. But I think you need to get to know and trust the team who will care for you.

We’ll start to adjust your eating habits to get closer to the healthy options we’ll recommend after surgery so the change isn’t so abrupt. It won’t be anything crazy – we focus on fruits, vegetables, and lean proteins, with a lower emphasis on carbs. This is a healthy diet we’d recommend almost anyone to follow.

The next step is to see your primary care doctor to have routine lab tests taken. You’ll also visit at least twice with our mental health specialist to talk about reasonable expectations for your weight loss and how to manage stress before and after the surgery. A nurse practitioner will meet with you to make sure you’re completing each step.

The weight loss clinic is next door to the Sleep Medicine Center at Hallmark Health, so it’s easy to schedule a sleep study if we need to address sleep apnea issues before the surgery. We’ll also check in with your specialty care doctor if you have one, such as an endocrinologist for diabetes or a cardiologist for heart health concerns. We want to make sure what we do in our program won’t affect other aspects of your health.

Finally, my colleagues and I have a roundtable to touch base and make sure we all agree you are ready for weight loss surgery. Once we all agree, you will have a final office visit with me to get your paperwork squared away, and then we’ll schedule the surgery. That’s a lot of work for something that is supposedly the “easy way out!”

Choosing a local weight loss center is important

As you can see, there are a lot of steps required before bariatric surgery. And though we try to group your appointments with various specialists when we can, it’s still a lot of trips to commit to when you have a job, a family, or other obligations.

Since our clinic is in Medford, there’s no need to travel to Boston for appointments or your surgery. And our locale helps cut down on post-surgery travel, too. We’ll want to see you several times in the year following surgery to make sure you are healthy and meeting your weight loss goals. After the first year, we’ll want to see you annually to follow up.

Being far away from your doctors makes follow-up problematic. If there are complications, you want to quickly get in to the clinic to address them. The surgery is just one day in this whole thing. If you don’t follow up afterward, you’ll be much less likely to succeed in your weight loss, and more susceptible to complications such as infection, dehydration, or constipation.

Life after weight loss surgery isn’t as restrictive as you may think

Lifestyle changes are necessary after bariatric surgery, but if you’re committed, the process is less disruptive than many people expect. The goal is to change your eating habits and your relationship with food in a positive way. Because we’re operating on your digestive organs, you’ll be on a liquid diet for a bit, then graduate to soft foods, and finally to regular foods as your body acclimates to digesting differently.

We’ll counsel you on how to eat a healthier diet with smaller portions and ask that you take dietary supplements to make sure you get the proper nutrients. We’ll also emphasize the importance of exercise to maintain weight loss and lead a healthy lifestyle.

Short term, you’ll have to take it easy while you recover. Long term, you’ll have no work, exercise or lifting restrictions. People often are able to be more active and are much more energetic after the first month. You may find yourself in a positive spiral after losing the first 20 pounds – many patients get excited after reaching this milestone, which encourages them to be more active and lose more weight.

Weight loss surgery isn’t the only option

Some people struggle with their weight, but don’t meet the criteria, or simply don’t want to, have weight loss surgery. For these folks who are in the BMI range of 30 or more, we offer a non-surgical weight loss program.

This is a 12-week structured program in which we help people 18 and older develop healthy eating and exercise habits. The goal for participants is 5 percent to 10 percent weight loss over the course of the program. In 2017, the average weight loss for participants was 8.4 percent.

People can join the program on their own, or they can be referred by their primary care doctor. Most insurances cover in-office visits, but visits with the athletic trainer are not covered by insurance.

When you join the program, you’ll meet with me as well as our dietitian to set yourself up for success. You’ll then meet with our athletic trainer at least six times to develop and maintain a safe, effective exercise program. We don’t hold group meetings – everyone gets personal attention. Our program doesn’t replace working out at home or a gym – we want to help set you on a healthy path and develop healthy habits to continue independently when the program ends.

I work with a roundtable of specialists to support people in our non-surgical weight loss program, including dietitians, a mental health clinical nurse specialist, and an athletic trainer. We use electronic medical records to easily and securely update one another on your progress.

It’s hard to get out the door to walk or jog, let alone get the courage to have weight loss surgery or join a weight loss program. But when it’s all said and done, most of our patients wish they had done it sooner.

Weight loss surgery is a lifelong commitment, and if you’re willing to put in the work and stick with it, you can see long-term results. If you’re interested in learning more about weight loss surgery, register online for a free seminar.

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